ArticleFrontiers in oncology2022
Pretreatment neutrophil to lymphocyte ratio as prognostic factor in metastatic breast cancer treated with cyclin dependent kinase 4/6 inhibitors.
Article in Frontiers in oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- Efficacy and Safety of Cyclin-Dependent Kinase 4/6 Inhibitors in Patients with Breast Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials and Real-World Studies.Targeted oncology · 2025Pooled it
- Neutrophil to Lymphocyte ratio as a predictor for immune-related adverse events in cancer patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis.Frontiers in immunology · 2023Pooled it
- Predictive Role of Serum Inflammatory Markers in Metastatic Luminal A/B Breast Cancers Receiving CDK-4/6 Inhibitors Therapy.Immunity, inflammation and disease · 2026Article
- Proton-pump inhibitors and palbociclib or abemaciclib in endocrine-sensitive breast cancer treatment.Scientific reports · 2026Article
- Ki-67 and Platelet-to-Lymphocyte Ratio (PLR) as Predictors of Progression-Free Survival in Metastatic Breast Cancer Receiving CDK4/6 Inhibitors: Clinical Implications.Cancer management and research · 2026Article
- Article
- Prognostic value of neutrophil-to-lymphocyte ratio and CA 19-9 in overall survival of patients with peritoneal carcinomatosis of colorectal cancer undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.World journal of surgical oncology · 2025Article
- Pre-existing and emerging immune-mediated diseases in patients with breast cancer undergoing cyclin-dependent kinases 4/6 inhibitors and endocrine therapy.The oncologist · 2025Article
- Article
- Significance of Neutrophil-to-Lymphocyte Ratio in Predicting the Efficacy of Anamorelin for Cancer Cachexia.Cureus · 2025Article
- Beyond clinical trials: CDK4/6 inhibitor efficacy predictors and nomogram model from real-world evidence in metastatic breast cancer.Cancer innovation · 2024Article
- Association of Neutrophil-to-Lymphocyte Ratio and Absolute Lymphocyte Count With Clinical Outcomes in Advanced Breast Cancer in the MONARCH 2 Trial.The oncologist · 2024Article
- Ratios of monocytes and neutrophils to lymphocytes in the blood predict benefit of CDK4/6 inhibitor treatment in metastatic breast cancer.Scientific reports · 2023Article
- Immunobiology of cancer stem cells and their immunoevasion mechanisms.Molecular biology reports · 2023Review
Corrections and comments
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Authors and funding
14 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Cyclin dependent kinase inhibitors (CdK4/6i) changed the course of hormone receptor positive (HR+) HER2 negative (HER2-) metastatic breast cancer (mBC). To date, no factors have been shown to predict response to CdK4/6i. Neutrophil-to-lymphocyte ratio (NLR), an indicator of the host systemic inflammatory response, is an independent prognostic factor for survival in cancers. We conducted this study to evaluate the impact of NLR on survival in mBC patients treated with first line CdK4/6i. Methods: All mBC patients treated with first line CdK4/6i between November 2015 and December 2019 were retrospectively included. The biomarker threshold was defined using ROC curves. We analyzed progression free survival (PFS), overall survival (OS), 12-month PFS and response rate according to NLR in univariable and multivariable analysis. Results: A total of 126 patients treated with palbociclib (n=101), ribociclib (n=18) or abemaciclib (n=7) were included, with a median follow-up of 33 months [range: 2.9-57]. Median age was 65 years [29-86], 40% patients had good performance status (ECOG-PS 0). Most patients (71%) were included at the metastatic relapse stage and 29% had only bone metastases. Median PFS and median OS were 27 and 51 months, respectively. High NLR (≥ 2.53) was significantly associated with worse PFS (Hazard Ratio (HR)=0.50, CI Conclusion: High NLR was associated with worse PFS and OS in HR+ HER2- mBC patients treated with first line CdK4/6i. NLR is a reliable and inexpensive prognostic marker, easily accessible in routine clinical practice, which could help optimize the therapeutic strategy. These results need to be confirmed in larger prospective studies.
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